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Organization

CAROLINAS PHYSICIANS NETWORK, INC

Active
Parent organization
CAROLINAS PHYSICIANS NETWORK, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
CAROLINAS PHYSICIANS NETWORK, INC
Authorized official
MISS THOMAS FORD LAYMON (SVP)
(704) 631-0002
Entity
Organization

Contact information

Practice address
420 PARK ST, SUITE 105A, BELMONT, NC 28012-3393
(704) 631-1820
Mailing address
PO BOX 602148, CHARLOTTE, NC 28260-2148
(704) 631-1820

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1780077099
MEDICAID DME
NC
05
1780077099
NC
Enumeration date
03/11/2015
Last updated
08/09/2016
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